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Editor's Page
For Safety's Sake, They've Put Animosity Aside
Dan O'Connor
Publish Date: October 10, 2007

We were skeptical when we first heard that the managers of eight hospitals and three outpatient centers within driving distance of each other in Indiana and Kentucky had joined forces to formulate a set of surgical standards that they'd all abide by.

Eleven facilities used to fighting for the same slice of surgical pie playing nice and sharing with each other? Yeah, right, when surgeons show up on time. No, really, we're serious, the members of the Community Patient Safety Coalition told us.

Indeed, they are. And we applaud them. You might want to emulate them.

They've formed their own United Nations of Surgery, setting aside their own interests in the name of patient safety and service to surgeons.

"Though we may be competitive, as a community we want the public to know that all the facilities and the physicians that use them want the safest and best practices for all patients," says Denise Lamberton, RN, executive director of the Welborn Clinic Surgery Center in Evansville, Ind.

They've standardized key processes and abolished the varying do's and don'ts that used to govern their facilities so that surgeons and staff do certain things certain ways all the time, regardless of which facility a patient happens to wind up at. Their goal is to meet and exceed the National Patient Safety Goals. A couple examples:

  • Surgical site marking. "There had been variation in the process because we're hosting surgeons from many different institutions," says Aprile L. Sandefur, RN, co-chair of the coalition and infection control specialist at Deaconess Hospital in Evansville, Ind. Rather than leaving it up to the whim of the surgeon who's holding the skin marker to mark the site with an ?X,' a ?Yes' or a ?No' on the site he's not operating on, the coalition adopted one process: mark ?Yes' on the surgical site.
  • Drug abbreviations. The coalition prohibits 17 abbreviations. Write out ?units' rather than using ?u,' which when handwritten can be mistaken for a zero. Trailing zeros are no-no's (a 5mg order written as 5.0mg can cause a tenfold increase in dosing if you don't see the decimal) and leading zeros are mandatory (0.2mg does the job better than .2mg).

They say that sharing has no place in the business of surgery, where the name of the game is to fill your ORs with more of everything than the next guy. But maybe the Community Patient Safety Coalition is proof that you can let your guard down a little and come together for a common good.

"Our first meeting was very quiet. Nobody wanted to speak up," says Jennifer Huston, MSN, CNOR, surgical services manager at The Women's Hospital in Newburgh, Ind. "But we broke down the barriers and put aside any animosities."